detection of postoperative intestinal ischemia in small bowel transplants检测在小肠移植术后肠道缺血.pdfVIP

Hindawi Publishing Corporation Journal of Transplantation Volume 2012, Article ID 970630, 6 pages doi:10.1155/2012/970630 Review Article Detection of Postoperative Intestinal Ischemia in Small Bowel Transplants Hanne Birke-Sorensen Institute of Clinical Medicine, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark Correspondence should be addressed to Hanne Birke-Sorensen, hanne.birke@ki.au.dk Received 20 July 2012; Accepted 10 October 2012 Academic Editor: Thierry Yandza Copyright © 2012 Hanne Birke-Sorensen. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Small bowel transplantation is acknowledged as auto- and allotransplantation. In both instances, there is up to a 4%–10% risk of postoperative ischemia, and as the small bowel is extremely susceptible to ischemia, the timely diagnosis of ischemia is important. The location of the transplant, whether it is buried in the abdominal cavity or in the neck region, increases the challenge, as monitoring becomes more difficult and the consequences of neglect more dangerous. All methods for the early detection of post- operative ischemia in small bowel transplants are described together with the requirements of the ideal monitoring method. A small bowel transplant can be inspected directly or indirectly; the blood flow can be monitored by Doppler or by photoplethysmography, and the consequences of the blood flow can be monitored. The ideal monitoring method should be reliable, fast, minimally invasive, safe, objective, easy, cheap, and comfortable. No monitoring methods today fulfill the criteria of the ideal monitoring method, and